AB1375 PERFORMANCE OF ULTRASOUND EXAMINATION OF INSERTIONS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASES.
Authors: G. Gainullina, E. Kirillova, A. Odincova, D. Abdulganieva
Journal: Annals of the Rheumatic Diseases (2022)

Background Enthesitis is one of extraintestinal manifestation of inflammatory bowel diseases (IBD). US examination appears to be a useful imaging technique, specifically in identifying enthesis involvement in patients with inflammatory bowel diseases [1]. Objectives The aim of the study was to perform the individual anatomical site analysis for the evaluation of enthesopathies in patients with inflammatory bowel diseases (IBD). Methods A total of 95 patients with IBD were prospectively enrolled, 55 with ulcerative colitis (UC) and 40 with Crohn’s disease (CD). All patients underwent ultrasound in B-mode and PD-mode, to assess the presence of entesitis. Thirty four different anatomical sites (insertions of short head of the biceps brachii, coracoacromial ligament (2 sites), infrascapularis, supraspinatus, infraspinatus, triceps brachii, flexor carpi ulnaris, flexor carpi radialis, extensor carpi ulnaris, extensors carpi radialis (2), gluteus minimum, gluteus medium, spina iliaca anterior superior/inferior, ischiadicus tuberositas, medial collateral ligament of knee (2 sites), lateral collateral ligament of knee (2 sites), patellar ligament (2 sites), pes anserinus, biceps femoris, semimembranosus, quadriceps femoris, tibialis anterior, tibialis posterior, peroneus brevis, achille, plantar fascia, medial epicondyle, lateral epicondyle) were evaluated bilaterally with total count 6460. If typical ultrasound features, such as entheseal hypoechogenicity, entheseal thickening, presence of vascularization, were present, acute lesions was diagnosed. Bone erosions and enthesophytes were considered as chronic lesions. Fisher’s exact test was used to calculate differences. Results The number of positive enthesitis sites was 293/6460 (4.5%), 177 positive sites in patients with UC versus 116 in patients CD (4,7% vs 4,2%). Most often involved sites were pes anserinus and proximal insertion of medial collateral ligament of knee (Figure 1). The number of positive vascularizated enthesitis sites was 62/6460 (1.0%), 40 in patients with UC versus 22 in patients with CD (1,0% vs 0,8%). Proximal insertion of medial collateral ligament of knee was involved more often then other sites. At least one positive enthesitis was detected in 72 (76%) patients, 42 (76%) patients with UC versus 30 (75%) patients with CD. Vascularizated enthesitis were detected in 35 (37%) patients, 21 (38%) patients with UC versus 14 (35%) patients with CD. There are not statistically significant differences between UС and CD. Signs of chronic lesion were often detected. The number of sites with erosions was 313/6460 (4.8%), 178 (4,8%) in patients with UC versus 135 (5,0%) in patients CD. Enthesophytes of insertion were detected in 91/6460 (1, 4%) sites, 41 (1,1%) in patients with UC versus 40 (1,5%) in patients CD. Most often erosion was detected in insertion of medial collateral ligament of knee (both sites) and enthesophyte was found in insertion of quadriceps femoris. There are not statistically significant differences between UС and CD. Conclusion Enthesis abnormalities are often features detected by ultrasound in patients with IBD. Most often involved site is medial collateral ligament of knee. There are not significant differences between UС and CD patients. References [1]Bandinelli F., Milla M., Genise S. et al. Ultrasound discloses entheseal involvement in inactive and low active inflammatory bowel disease without clinical signs and symptoms of spondyloarthropathy. Rheumatology (Oxford). 2011; 50 (7): 1275-1279. doi: 10.1093/rheumatology/keq447 Disclosure of Interests None declared